Provider Demographics
NPI:1285836650
Name:BARRISH, BERNARD IVAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:IVAN
Last Name:BARRISH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:447 ROUTE 10
Mailing Address - Street 2:SUITE 9
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869
Mailing Address - Country:US
Mailing Address - Phone:973-361-4018
Mailing Address - Fax:973-361-5534
Practice Address - Street 1:447 ROUTE 10
Practice Address - Street 2:SUITE 9
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869
Practice Address - Country:US
Practice Address - Phone:973-361-4018
Practice Address - Fax:973-361-5534
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI009280001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics